Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

THREE RIVERS HEALTH

Three Rivers, MI · CCN 230015 · Rates published

Your selected procedure

You selected 93306 (CPT)

COMPLETE ECHO W/COLOR FLOW DOPPLR CHG ONLY

This hospital’s price: $234 across 31 payers · range $67-$2,112

Source: https://www.beaconhealthsystem.org/wp-content/uploads/2026/05/451257972_Three-Rivers-Health_standardcharges.csv?v=3 · observed 2026-10-16

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

41,183 distinct procedures filed
71 distinct payers
1,258,064 rate rows
2026-10-16 last MRF observed
Data quality

1,227,424 of 1,258,064 rate rows are consumer-grade (97.6%)

30,640 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 14,210
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 13,786
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,584
placeholder amount (≤ $0.02) — excluded from medians 617
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 284
percent-of-charges filed in the dollar field — excluded from medians 150
template filing: same amount across many unrelated codes — excluded 9
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.beaconhealthsystem.org/wp-content/uploads/2026/03/451257972_Three-Rivers-Health_standardcharges.csv
Found on page https://www.beaconhealthsystem.org/hospital-chargemaster/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 6d47b9216d21d368… · 30,563,978 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj- Atidarsagene Autotemcel 9 $2,414,680.00 $4,730,250.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj- Hemgenix- Per Tx Dose 9 $1,975,302.94 $3,869,530.00 $3,685,266.67 nat. median
$3,705,478
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $1,777,623.95 $4,974,693.89 $3,316,462.59 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj- Lovotibeglogene Autotem 10 $1,741,166.91 $4,872,668.58 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj- Betibeglogene Autotemce 10 $1,578,916.64 $4,418,610.00 $2,945,740.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $1,315,939.29 $4,333,725.00 $2,455,110.61 nat. median
$2,467,386
1.0× median
J3392
HCPCS 		Inj- Exagamglogene Autotem 10 $1,249,952.00 $3,498,000.00 $2,332,000.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $413,052.32 $1,155,930.00 $770,620.00 nat. median
$813,967
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $317,165.24 $887,589.30 $591,726.20 nat. median
$739,258
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $303,305.76 $848,803.43 $565,868.95 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $301,520.47 $843,807.29 $562,538.19 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $298,722.41 $835,976.90 $557,317.93 nat. median
$622,450
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $285,811.37 $799,845.26 $533,230.17 nat. median
$608,239
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $262,267.27 $733,956.92 $489,304.61 nat. median
$591,721
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 10 $309,102.54 $647,742.00 $309,102.54 nat. median
$359,454
0.9× median
5834
APR_DRG 		Neonate With Ecmo 5 $292,611.04 $292,611.04 $292,611.04 nat. median
$307,206
1.0× median
5834
OTHER 		Neonate With Ecmo 5 $292,611.04 $292,611.04 $292,611.04 nat. median
$372,748
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $149,142.00 $417,375.00 $278,250.00 nat. median
$319,951
0.9× median
J3403
HCPCS 		Revakinagene- Per Implant 10 $138,020.00 $386,250.00 $257,500.00 nat. median
$265,000
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $110,223.04 $308,460.00 $205,640.00 nat. median
$209,753
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $201,121.56 $420,358.50 $201,121.56 nat. median
$249,036
0.8× median
5884
OTHER 		Neonate Bwt <1500g W Major Procedure 5 $191,242.03 $191,242.03 $191,242.03 nat. median
$243,175
0.8× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $191,242.03 $191,242.03 $191,242.03 nat. median
$247,214
0.8× median
5833
APR_DRG 		Neonate With Ecmo 5 $189,725.36 $189,725.36 $189,725.36 nat. median
$244,017
0.8× median
5833
OTHER 		Neonate With Ecmo 5 $189,725.36 $189,725.36 $189,725.36 nat. median
$241,478
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 5 $157,437.62 $157,437.62 $157,437.62 nat. median
$202,993
0.8× median
1614
OTHER 		Implantable Heart Assist Systems 5 $157,437.62 $157,437.62 $157,437.62 nat. median
$188,156
0.8× median
6314
OTHER 		Neonate Birthwt >2499g W Other Major Procedure 5 $155,895.97 $155,895.97 $155,895.97 nat. median
$156,971
1.0× median
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 5 $155,895.97 $155,895.97 $155,895.97 nat. median
$133,164
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $153,585.11 $320,257.50 $153,585.11 nat. median
$198,418
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 10 $152,692.56 $318,378.00 $152,692.56 nat. median
$190,559
0.8× median
114
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 5 $145,701.73 $145,701.73 $145,701.73 nat. median
$10,131
outlier · 14.4×
114
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 5 $145,701.73 $145,701.73 $145,701.73 nat. median
$123,836
1.2× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 $143,255.28 $143,255.28 $143,255.28 nat. median
$154,011
0.9× median
6304
OTHER 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 $143,255.28 $143,255.28 $143,255.28 nat. median
$177,388
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $136,869.12 $136,869.12 $136,869.12 nat. median
$155,939
0.9× median
8414
OTHER 		Extensive Third Degree Burns With Skin Graft 5 $136,869.12 $136,869.12 $136,869.12 nat. median
$140,709
1.0× median
6094
OTHER 		Neonate Bwt 1500-2499g W Major Procedure 5 $126,015.66 $126,015.66 $126,015.66 nat. median
$163,006
0.8× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 5 $126,015.66 $126,015.66 $126,015.66 nat. median
$165,000
0.8× median
5883
OTHER 		Neonate Bwt <1500g W Major Procedure 5 $123,561.93 $123,561.93 $123,561.93 nat. median
$168,056
0.7× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $123,561.93 $123,561.93 $123,561.93 nat. median
$175,204
0.7× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $119,598.28 $119,598.28 $119,598.28 nat. median
$170,082
0.7× median
74
OTHER 		Allogeneic Bone Marrow Transplant 5 $119,598.28 $119,598.28 $119,598.28 nat. median
$11,409
outlier · 10.5×
5934
OTHER 		Neonate Birthwt 750-999g Without Major Procedure 5 $112,321.89 $112,321.89 $112,321.89 nat. median
$151,840
0.7× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 5 $112,321.89 $112,321.89 $112,321.89 nat. median
$151,838
0.7× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 5 $111,225.09 $111,225.09 $111,225.09 nat. median
$162,342
0.7× median
5914
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 5 $111,225.09 $111,225.09 $111,225.09 nat. median
$157,493
0.7× median
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 2 $87,444.30 $132,921.00 $110,182.65 nat. median
$70,732
1.6× median
Q0480
HCPCS 		Driver Pneumatic Vad- Rep 10 $58,277.79 $163,090.83 $108,727.22 nat. median
$111,503
1.0× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 5 $106,436.25 $106,436.25 $106,436.25 nat. median
$145,061
0.7× median

Other procedures at this hospital

Browse this hospital's 41,183 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj- Atidarsagene Autotemcel 26 9 — — $2,414,680.00 $4,730,250.00 $4,505,000.00 2026-10-16
J1411 HCPCS Inj- Hemgenix- Per Tx Dose 26 9 — — $1,975,302.94 $3,869,530.00 $3,685,266.67 2026-10-16
J1413 HCPCS Inj Delandistrogene Mox Rokl 28 10 — — $1,777,623.95 $4,974,693.89 $3,316,462.59 2026-10-16
J3394 HCPCS Inj- Lovotibeglogene Autotem 28 10 — — $1,741,166.91 $4,872,668.58 $3,248,445.72 2026-10-16
J3393 HCPCS Inj- Betibeglogene Autotemce 28 10 — — $1,578,916.64 $4,418,610.00 $2,945,740.00 2026-10-16
J3399 HCPCS Inj Onase Abepar-xioi Treat 30 10 — — $1,315,939.29 $4,333,725.00 $2,455,110.61 2026-10-16
J3392 HCPCS Inj- Exagamglogene Autotem 28 10 — — $1,249,952.00 $3,498,000.00 $2,332,000.00 2026-10-16
Q2057 HCPCS Afamitresgene Autoleucel 28 10 — — $413,052.32 $1,155,930.00 $770,620.00 2026-10-16
Q2042 HCPCS Tisagenlecleucel Car-pos T 30 10 — — $317,165.24 $887,589.30 $591,726.20 2026-10-16
Q2056 HCPCS Ciltacabtagene Car-pos T 30 10 — — $303,305.76 $848,803.43 $565,868.95 2026-10-16
Q2054 HCPCS Lisocabtagene Mara Car Pos T 30 10 — — $301,520.47 $843,807.29 $562,538.19 2026-10-16
Q2055 HCPCS Idecabtagene Vicleucel Car 30 10 — — $298,722.41 $835,976.90 $557,317.93 2026-10-16
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 30 10 — — $285,811.37 $799,845.26 $533,230.17 2026-10-16
Q2053 HCPCS Brexucabtagene Car Pos T 30 10 — — $262,267.27 $733,956.92 $489,304.61 2026-10-16
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 20 10 — — $309,102.54 $647,742.00 $309,102.54 2026-10-16
5834 APR_DRG Neonate With Ecmo 5 5 — — $292,611.04 $292,611.04 $292,611.04 2026-10-16
5834 OTHER Neonate With Ecmo 5 5 — — $292,611.04 $292,611.04 $292,611.04 2026-05-13
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 28 10 — — $149,142.00 $417,375.00 $278,250.00 2026-10-16
J3403 HCPCS Revakinagene- Per Implant 28 10 — — $138,020.00 $386,250.00 $257,500.00 2026-10-16
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 28 10 — — $110,223.04 $308,460.00 $205,640.00 2026-10-16
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 18 9 — — $201,121.56 $420,358.50 $201,121.56 2026-10-16
5884 OTHER Neonate Bwt <1500g W Major Procedure 5 5 — — $191,242.03 $191,242.03 $191,242.03 2026-05-13
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $191,242.03 $191,242.03 $191,242.03 2026-10-16
5833 APR_DRG Neonate With Ecmo 5 5 — — $189,725.36 $189,725.36 $189,725.36 2026-10-16
5833 OTHER Neonate With Ecmo 5 5 — — $189,725.36 $189,725.36 $189,725.36 2026-05-13
1614 APR_DRG Implantable Heart Assist Systems 5 5 — — $157,437.62 $157,437.62 $157,437.62 2026-10-16
1614 OTHER Implantable Heart Assist Systems 5 5 — — $157,437.62 $157,437.62 $157,437.62 2026-05-13
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 5 5 — — $155,895.97 $155,895.97 $155,895.97 2026-10-16
6314 OTHER Neonate Birthwt >2499g W Other Major Procedure 5 5 — — $155,895.97 $155,895.97 $155,895.97 2026-05-13
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 10 — — $153,585.11 $320,257.50 $153,585.11 2026-10-16
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 22 10 — — $152,692.56 $318,378.00 $152,692.56 2026-10-16
114 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $145,701.73 $145,701.73 $145,701.73 2026-05-13
114 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $145,701.73 $145,701.73 $145,701.73 2026-10-16
6304 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $143,255.28 $143,255.28 $143,255.28 2026-05-13
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $143,255.28 $143,255.28 $143,255.28 2026-10-16
8414 OTHER Extensive Third Degree Burns With Skin Graft 5 5 — — $136,869.12 $136,869.12 $136,869.12 2026-05-13
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $136,869.12 $136,869.12 $136,869.12 2026-10-16
6094 OTHER Neonate Bwt 1500-2499g W Major Procedure 5 5 — — $126,015.66 $126,015.66 $126,015.66 2026-05-13
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 5 5 — — $126,015.66 $126,015.66 $126,015.66 2026-10-16
5883 OTHER Neonate Bwt <1500g W Major Procedure 5 5 — — $123,561.93 $123,561.93 $123,561.93 2026-05-13
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $123,561.93 $123,561.93 $123,561.93 2026-10-16
74 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $119,598.28 $119,598.28 $119,598.28 2026-05-13
74 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $119,598.28 $119,598.28 $119,598.28 2026-10-16
5934 OTHER Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $112,321.89 $112,321.89 $112,321.89 2026-05-13
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $112,321.89 $112,321.89 $112,321.89 2026-10-16
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $111,225.09 $111,225.09 $111,225.09 2026-10-16
5914 OTHER Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $111,225.09 $111,225.09 $111,225.09 2026-05-13
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 4 2 — — $87,444.30 $132,921.00 $110,182.65 2026-10-16
Q0480 HCPCS Driver Pneumatic Vad- Rep 28 10 — — $58,277.79 $163,090.83 $108,727.22 2026-10-16
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $106,436.25 $106,436.25 $106,436.25 2026-10-16
5882 OTHER Neonate Bwt <1500g W Major Procedure 5 5 — — $106,436.25 $106,436.25 $106,436.25 2026-05-13
5832 APR_DRG Neonate With Ecmo 5 5 — — $105,432.07 $105,432.07 $105,432.07 2026-10-16
5832 OTHER Neonate With Ecmo 5 5 — — $105,432.07 $105,432.07 $105,432.07 2026-05-13
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $103,458.96 $103,458.96 $103,458.96 2026-10-16
6034 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 5 5 — — $102,445.03 $102,445.03 $102,445.03 2026-05-13
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 5 5 — — $102,445.03 $102,445.03 $102,445.03 2026-10-16
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 22 10 — — $100,166.98 $207,771.00 $100,166.98 2026-10-16
94 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $94,807.55 $94,807.55 $94,807.55 2026-05-13
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $94,807.55 $94,807.55 $94,807.55 2026-10-16
44 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $94,120.75 $94,120.75 $94,120.75 2026-05-13
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $94,120.75 $94,120.75 $94,120.75 2026-10-16
7 MS_DRG Lung Transplant 18 9 — — $93,747.48 $194,253.00 $93,747.48 2026-10-16
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 5 5 — — $91,308.53 $91,308.53 $91,308.53 2026-10-16
5881 OTHER Neonate Bwt <1500g W Major Procedure 5 5 — — $91,308.53 $91,308.53 $91,308.53 2026-05-13
8424 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $88,230.96 $88,230.96 $88,230.96 2026-05-13
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $88,230.96 $88,230.96 $88,230.96 2026-10-16
1604 OTHER Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $87,323.03 $87,323.03 $87,323.03 2026-05-13
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $87,323.03 $87,323.03 $87,323.03 2026-10-16
14 MS_DRG Allogeneic Bone Marrow Transplant 18 9 — — $87,106.46 $180,268.50 $87,106.46 2026-10-16
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $85,641.94 $85,641.94 $85,641.94 2026-10-16
5913 OTHER Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $85,641.94 $85,641.94 $85,641.94 2026-05-13
113 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $85,202.81 $85,202.81 $85,202.81 2026-05-13
113 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $85,202.81 $85,202.81 $85,202.81 2026-10-16
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 2 — — $65,447.54 $99,484.50 $82,466.02 2026-10-16
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 9 — — $82,219.17 $169,977.00 $82,219.17 2026-10-16
209 MS_DRG Kidney And Urinary Tract Signs And Symptoms Age 0-17 22 10 — — $82,126.58 $169,782.00 $82,126.58 2026-10-16
1613 OTHER Implantable Heart Assist Systems 5 5 — — $82,116.39 $82,116.39 $82,116.39 2026-05-13
1613 APR_DRG Implantable Heart Assist Systems 5 5 — — $82,116.39 $82,116.39 $82,116.39 2026-10-16
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 10 — — $80,006.69 $165,318.00 $80,006.69 2026-10-16
212 MS_DRG Testes Procedures Age 0-17 22 10 — — $78,958.85 $163,111.50 $78,958.85 2026-10-16
1612 OTHER Implantable Heart Assist Systems 5 5 — — $78,849.43 $78,849.43 $78,849.43 2026-05-13
1612 APR_DRG Implantable Heart Assist Systems 5 5 — — $78,849.43 $78,849.43 $78,849.43 2026-10-16
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $78,168.72 $78,168.72 $78,168.72 2026-10-16
0100T OTHER Prosth Retina Receive&gen 17 7 — — $77,913.19 $77,913.19 $77,913.19 2026-01-01
5933 OTHER Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $77,554.92 $77,554.92 $77,554.92 2026-05-13
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $77,554.92 $77,554.92 $77,554.92 2026-10-16
5831 OTHER Neonate With Ecmo 5 5 — — $76,786.44 $76,786.44 $76,786.44 2026-05-13
5831 APR_DRG Neonate With Ecmo 5 5 — — $76,786.44 $76,786.44 $76,786.44 2026-10-16
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 4 2 — — $60,355.65 $91,744.50 $76,050.07 2026-10-16
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $75,103.27 $75,103.27 $75,103.27 2026-10-16
5891 OTHER Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $75,103.27 $75,103.27 $75,103.27 2026-05-13
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 9 — — $74,944.18 $154,657.50 $74,944.18 2026-10-16
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $73,903.98 $73,903.98 $73,903.98 2026-10-16
5892 OTHER Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $73,903.98 $73,903.98 $73,903.98 2026-05-13
112 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $73,235.91 $73,235.91 $73,235.91 2026-05-13
112 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $73,235.91 $73,235.91 $73,235.91 2026-10-16
215 MS_DRG Other Heart Assist System Implant 22 10 — — $72,426.10 $149,355.00 $72,426.10 2026-10-16
5893 OTHER Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $72,340.99 $72,340.99 $72,340.99 2026-05-13
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 5 5 — — $72,340.99 $72,340.99 $72,340.99 2026-10-16
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 10 — — $71,185.22 $146,742.00 $71,185.22 2026-10-16
152470221 OTHER Polatuzumab Vedotin-piiq 140 Mg/7 Ml Inj 15 10 $94,740.29 $61,581.19 35% off $18,948.06 $94,740.29 $71,055.22 2026-05-13
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $68,955.40 $68,955.40 $68,955.40 2026-10-16
6303 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $68,955.40 $68,955.40 $68,955.40 2026-05-13
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 28 10 — — $36,154.63 $101,178.99 $67,452.66 2026-10-16
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 10 — — $65,677.51 $135,144.00 $65,677.51 2026-10-16
1611 APR_DRG Implantable Heart Assist Systems 5 5 — — $65,444.42 $65,444.42 $65,444.42 2026-10-16
1611 OTHER Implantable Heart Assist Systems 5 5 — — $65,444.42 $65,444.42 $65,444.42 2026-05-13
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $64,711.84 $64,711.84 $64,711.84 2026-10-16
5912 OTHER Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $64,711.84 $64,711.84 $64,711.84 2026-05-13
J9029 HCPCS Instill Adstiladrin- Tx Dose 28 10 — — $33,951.46 $95,013.42 $63,342.28 2026-10-16
850 MS_DRG Acute Leukemia With Other Procedures 22 10 — — $63,183.65 $129,892.50 $63,183.65 2026-10-16
366035 CDM Implant Neuroreceiver Stimulator 56 24 $78,916.95 $38,669.31 51% off $22,096.75 $78,916.95 $62,738.97 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 22 10 — — $61,548.16 $126,448.50 $61,548.16 2026-10-16
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 22 10 — — $61,359.38 $126,051.00 $61,359.38 2026-10-16
3034 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $61,207.09 $61,207.09 $61,207.09 2026-05-13
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $61,207.09 $61,207.09 $61,207.09 2026-10-16
84 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $60,975.04 $60,975.04 $60,975.04 2026-05-13
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $60,975.04 $60,975.04 $60,975.04 2026-10-16
73 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $59,022.87 $59,022.87 $59,022.87 2026-05-13
73 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $59,022.87 $59,022.87 $59,022.87 2026-10-16
152481777 OTHER Relatlimab-rmbw-nivolumab 80 Mg-240 Mg/20 Ml 15 10 $78,476.00 $51,009.40 35% off $15,695.20 $78,476.00 $58,857.00 2026-05-13
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $58,476.04 $58,476.04 $58,476.04 2026-10-16
43 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $58,476.04 $58,476.04 $58,476.04 2026-05-13
38240 OTHER Transplt Allo Hct/donor 15 10 — — $6,325.00 $87,659.58 $58,439.72 2026-05-13
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 10 — — $57,551.29 $118,032.00 $57,551.29 2026-10-16
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 4 2 — — $45,448.06 $69,084.00 $57,266.03 2026-10-16
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $56,985.90 $56,985.90 $56,985.90 2026-10-16
8504 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $56,985.90 $56,985.90 $56,985.90 2026-05-13
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $56,977.58 $56,977.58 $56,977.58 2026-10-16
54 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $56,977.58 $56,977.58 $56,977.58 2026-05-13
8514 OTHER Gender Related Procedures 5 5 — — $56,851.14 $56,851.14 $56,851.14 2026-05-13
8514 APR_DRG Gender Related Procedures 5 5 — — $56,851.14 $56,851.14 $56,851.14 2026-10-16
A9543 HCPCS Y90 Ibritumomab- Rx 30 10 — — $30,457.96 $108,036.36 $56,824.55 2026-10-16
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 10 — — $56,194.29 $115,174.50 $56,194.29 2026-10-16
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 22 10 — — $55,958.52 $114,678.00 $55,958.52 2026-10-16
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 10 — — $55,778.29 $114,298.50 $55,778.29 2026-10-16
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 30 10 — — $29,625.96 $89,069.41 $55,272.32 2026-10-16
152470144 OTHER Coagulation Factor VIIa 5,000 Mcg (5 Mg) IV Inj 15 10 $72,360.00 $47,034.00 35% off $14,472.00 $72,360.00 $54,270.00 2026-05-13
6024 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $53,773.57 $53,773.57 $53,773.57 2026-05-13
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $53,773.57 $53,773.57 $53,773.57 2026-10-16
71 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $53,522.26 $53,522.26 $53,522.26 2026-10-16
71 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $53,522.26 $53,522.26 $53,522.26 2026-05-13
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 10 — — $52,919.73 $108,279.00 $52,919.73 2026-10-16
10 MS_DRG Pancreas Transplant 18 9 — — $52,614.13 $107,635.50 $52,614.13 2026-10-16
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 22 10 — — $52,592.77 $107,590.50 $52,592.77 2026-10-16
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 5 5 — — $52,507.16 $52,507.16 $52,507.16 2026-10-16
6134 OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 5 5 — — $52,507.16 $52,507.16 $52,507.16 2026-05-13
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 18 9 — — $52,321.38 $107,019.00 $52,321.38 2026-10-16
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 10 — — $52,291.45 $106,956.00 $52,291.45 2026-10-16
1624 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $52,231.92 $52,231.92 $52,231.92 2026-05-13
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $52,231.92 $52,231.92 $52,231.92 2026-10-16
220216 CDM Ipilimumab Vl 200mg, Per 1mg 66 28 $66,590.70 $32,629.44 51% off $18,645.40 $66,590.70 $51,940.75 2026-01-01
220489 CDM Ipilimumab Vl 200mg, Per 1mg 66 28 $66,590.70 $32,629.44 51% off $18,645.40 $66,590.70 $51,940.75 2026-01-01
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $51,043.03 $51,043.03 $51,043.03 2026-10-16
5932 OTHER Neonate Birthwt 750-999g Without Major Procedure 5 5 — — $51,043.03 $51,043.03 $51,043.03 2026-05-13
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 22 10 — — $50,734.32 $103,677.00 $50,734.32 2026-10-16
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 10 — — $50,492.83 $103,168.50 $50,492.83 2026-10-16
955 MS_DRG Craniotomy For Multiple Significant Trauma 22 10 — — $49,447.13 $100,966.50 $49,447.13 2026-10-16
317 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 22 10 — — $49,129.44 $100,297.50 $49,129.44 2026-10-16
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 22 10 — — $49,094.54 $100,224.00 $49,094.54 2026-10-16
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $48,741.23 $48,741.23 $48,741.23 2026-10-16
53 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $48,741.23 $48,741.23 $48,741.23 2026-05-13
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $48,694.40 $48,694.40 $48,694.40 2026-10-16
1674 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $48,694.40 $48,694.40 $48,694.40 2026-05-13
L7181 HCPCS Electronic Elbo Simultaneous 28 10 — — $25,926.73 $72,556.14 $48,370.76 2026-10-16
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 10 — — $48,337.33 $98,629.50 $48,337.33 2026-10-16
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 10 — — $48,337.33 $98,629.50 $48,337.33 2026-10-16
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 22 10 — — $48,167.08 $98,271.00 $48,167.08 2026-10-16
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $47,485.74 $47,485.74 $47,485.74 2026-10-16
72 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $47,438.92 $47,438.92 $47,438.92 2026-05-13
72 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $47,438.92 $47,438.92 $47,438.92 2026-10-16
8634 APR_DRG Neonatal Aftercare 5 5 — — $47,431.11 $47,431.11 $47,431.11 2026-10-16
8634 OTHER Neonatal Aftercare 5 5 — — $47,431.11 $47,431.11 $47,431.11 2026-05-13
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 22 10 — — $47,335.79 $96,520.50 $47,335.79 2026-10-16
152470248 OTHER Luspatercept-aamt 75 Mg/1.5 Ml Inj 15 10 $62,790.00 $40,813.50 35% off $12,558.00 $62,790.00 $47,092.50 2026-05-13
L7180 HCPCS Electronic Elbow Sequential 28 10 — — $25,181.48 $70,470.57 $46,980.38 2026-10-16
6093 OTHER Neonate Bwt 1500-2499g W Major Procedure 5 5 — — $46,744.84 $46,744.84 $46,744.84 2026-05-13
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 5 5 — — $46,744.84 $46,744.84 $46,744.84 2026-10-16
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 5 5 — — $46,075.73 $46,075.73 $46,075.73 2026-10-16
6033 OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 5 5 — — $46,075.73 $46,075.73 $46,075.73 2026-05-13
6124 OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 5 5 — — $45,731.81 $45,731.81 $45,731.81 2026-05-13
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 5 5 — — $45,731.81 $45,731.81 $45,731.81 2026-10-16
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $45,711.52 $45,711.52 $45,711.52 2026-10-16
1603 OTHER Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $45,711.52 $45,711.52 $45,711.52 2026-05-13
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 2 — — $36,096.16 $54,868.50 $45,482.33 2026-10-16
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 22 10 — — $45,153.94 $91,926.00 $45,153.94 2026-10-16
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 22 10 — — $45,103.36 $91,819.50 $45,103.36 2026-10-16
J9226 HCPCS Supprelin La Implant 30 10 — — $24,131.07 $71,485.59 $45,020.65 2026-10-16
232 MS_DRG Coronary Bypass With Ptca Without Mcc 22 10 — — $44,685.24 $90,939.00 $44,685.24 2026-10-16
33276 OTHER Insj Phrnc Nrv Stim Sys 15 10 — — $12,334.00 $66,698.84 $44,465.89 2026-05-13
33276 CPT Insj Phrnc Nrv Stim Sys 15 10 — — $12,334.00 $66,698.84 $44,465.89 2026-10-16
0266T CPT Implt/rpl Crtd Sns Dev Total 30 10 — — $12,334.00 $66,698.84 $44,465.89 2026-10-16
152470181 OTHER Ocrelizumab 300 Mg/10 Ml Inj 15 10 $59,144.00 $38,443.60 35% off $11,828.80 $59,144.00 $44,358.00 2026-05-13
28 MS_DRG Spinal Procedures With Mcc 22 10 — — $44,298.44 $90,124.50 $44,298.44 2026-10-16
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 22 10 — — $44,286.32 $90,099.00 $44,286.32 2026-10-16
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $44,033.55 $44,033.55 $44,033.55 2026-10-16
93 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $44,033.55 $44,033.55 $44,033.55 2026-05-13
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 22 10 — — $43,976.46 $89,446.50 $43,976.46 2026-10-16
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 20 10 — — $43,836.84 $89,152.50 $43,836.84 2026-10-16
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 18 9 — — $43,738.54 $88,945.50 $43,738.54 2026-10-16
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 5 5 — — $43,524.18 $43,524.18 $43,524.18 2026-10-16
6804 OTHER Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 5 5 — — $43,524.18 $43,524.18 $43,524.18 2026-05-13
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 22 10 — — $43,303.31 $88,029.00 $43,303.31 2026-10-16
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 22 10 — — $43,276.25 $87,972.00 $43,276.25 2026-10-16
1764 OTHER Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 5 — — $43,071.00 $43,071.00 $43,071.00 2026-05-13
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 5 — — $43,071.00 $43,071.00 $43,071.00 2026-10-16
152470134 OTHER Atezolizumab 1200 Mg/20 Ml Inj 15 10 $57,272.00 $37,226.80 35% off $11,454.40 $57,272.00 $42,954.00 2026-05-13
8413 OTHER Extensive Third Degree Burns With Skin Graft 5 5 — — $42,702.10 $42,702.10 $42,702.10 2026-05-13
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $42,702.10 $42,702.10 $42,702.10 2026-10-16
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 22 10 — — $42,580.30 $86,506.50 $42,580.30 2026-10-16
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 10 — — $42,318.16 $85,954.50 $42,318.16 2026-10-16
213 MS_DRG Splenic Procedures Age 0-17 22 10 — — $42,151.48 $85,603.50 $42,151.48 2026-10-16
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 22 10 — — $42,098.76 $85,492.50 $42,098.76 2026-10-16
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $41,842.57 $41,842.57 $41,842.57 2026-10-16
3033 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $41,842.57 $41,842.57 $41,842.57 2026-05-13
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 10 — — $41,546.70 $84,330.00 $41,546.70 2026-10-16
8 MS_DRG Simultaneous Pancreas/kidney Transplant 18 9 — — $41,422.77 $84,069.00 $41,422.77 2026-10-16
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 10 — — $41,149.24 $83,493.00 $41,149.24 2026-10-16
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 22 10 — — $40,841.51 $82,845.00 $40,841.51 2026-10-16
6904 APR_DRG Acute Leukemia 5 5 — — $40,625.59 $40,625.59 $40,625.59 2026-10-16
6904 OTHER Acute Leukemia 5 5 — — $40,625.59 $40,625.59 $40,625.59 2026-05-13
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 22 10 — — $40,605.73 $82,348.50 $40,605.73 2026-10-16
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 5 5 — — $40,551.18 $40,551.18 $40,551.18 2026-10-16
6313 OTHER Neonate Birthwt >2499g W Other Major Procedure 5 5 — — $40,551.18 $40,551.18 $40,551.18 2026-05-13
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 22 10 — — $40,467.54 $82,057.50 $40,467.54 2026-10-16
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 22 10 — — $40,411.98 $81,940.50 $40,411.98 2026-10-16
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 22 10 — — $40,350.70 $81,811.50 $40,350.70 2026-10-16
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 18 9 — — $40,195.42 $81,484.50 $40,195.42 2026-10-16
204 OTHER Open Craniotomy For Trauma 5 5 — — $40,164.08 $40,164.08 $40,164.08 2026-05-13
204 APR_DRG Open Craniotomy For Trauma 5 5 — — $40,164.08 $40,164.08 $40,164.08 2026-10-16
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $40,099.04 $40,099.04 $40,099.04 2026-10-16
6074 OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $40,099.04 $40,099.04 $40,099.04 2026-05-13
152470078 OTHER Alteplase 100 Mg Inj 15 10 $52,803.00 $34,321.95 35% off $10,560.60 $52,803.00 $39,602.25 2026-05-13
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 10 — — $39,486.66 $79,992.00 $39,486.66 2026-10-16
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 22 10 — — $39,463.86 $79,944.00 $39,463.86 2026-10-16
152470237 OTHER Daratumumab-hyaluronidase-fihj 1800 Mg-30,000 Units/15 Ml Inj 15 10 $52,343.00 $34,022.95 35% off $10,468.60 $52,343.00 $39,257.25 2026-05-13
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 10 — — $39,208.85 $79,407.00 $39,208.85 2026-10-16
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 22 10 — — $39,084.18 $79,144.50 $39,084.18 2026-10-16
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 28 10 — — $20,776.77 $58,143.95 $38,762.63 2026-10-16
3124 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $38,754.59 $38,754.59 $38,754.59 2026-05-13
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $38,754.59 $38,754.59 $38,754.59 2026-10-16
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 22 10 — — $38,579.16 $78,081.00 $38,579.16 2026-10-16
653 MS_DRG Major Bladder Procedures With Mcc 22 10 — — $38,515.05 $77,946.00 $38,515.05 2026-10-16
6302 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $38,465.30 $38,465.30 $38,465.30 2026-05-13
6302 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 5 5 — — $38,465.30 $38,465.30 $38,465.30 2026-10-16
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 5 — — $38,434.08 $38,434.08 $38,434.08 2026-10-16
3614 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 5 — — $38,434.08 $38,434.08 $38,434.08 2026-05-13
913 OTHER Other Major Head And Neck Procedures 5 5 — — $38,432.00 $38,432.00 $38,432.00 2026-05-13
913 APR_DRG Other Major Head And Neck Procedures 5 5 — — $38,432.00 $38,432.00 $38,432.00 2026-10-16
6023 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $38,067.27 $38,067.27 $38,067.27 2026-05-13
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 5 5 — — $38,067.27 $38,067.27 $38,067.27 2026-10-16
914 OTHER Other Major Head And Neck Procedures 5 5 — — $38,042.82 $38,042.82 $38,042.82 2026-05-13
914 APR_DRG Other Major Head And Neck Procedures 5 5 — — $38,042.82 $38,042.82 $38,042.82 2026-10-16
1784 OTHER External Heart Assist Systems 5 5 — — $37,825.85 $37,825.85 $37,825.85 2026-05-13
1784 APR_DRG External Heart Assist Systems 5 5 — — $37,825.85 $37,825.85 $37,825.85 2026-10-16
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 10 — — $37,402.38 $75,603.00 $37,402.38 2026-10-16
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 5 5 — — $37,112.52 $37,112.52 $37,112.52 2026-10-16
7404 OTHER Mental Illness Diagnosis With O.r. Procedure 5 5 — — $37,112.52 $37,112.52 $37,112.52 2026-05-13
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 22 10 — — $37,026.29 $74,811.00 $37,026.29 2026-10-16
9114 OTHER Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 5 5 — — $36,996.49 $36,996.49 $36,996.49 2026-05-13
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 5 5 — — $36,996.49 $36,996.49 $36,996.49 2026-10-16
228 MS_DRG Other Cardiothoracic Procedures With Mcc 22 10 — — $36,741.35 $74,211.00 $36,741.35 2026-10-16
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 10 — — $36,678.66 $74,079.00 $36,678.66 2026-10-16
152480923 OTHER Lanreotide 120 Mg/0.5 Ml SubQ Monthly Inj 30 10 $49,828.00 $32,388.20 35% off $9,604.20 $51,635.00 $36,664.04 2026-05-13
6254 APR_DRG Neonate Bwt 2000-2499g W Other Significant Condition 5 5 — — $36,625.52 $36,625.52 $36,625.52 2026-10-16
6254 OTHER Neonate Bwt 2000-2499g W Other Significant Condition 5 5 — — $36,625.52 $36,625.52 $36,625.52 2026-05-13
220523 CDM Ocrelizumab Vl 300mg, Per 1mg 66 28 $46,939.00 $23,000.11 51% off $13,142.92 $46,939.00 $36,612.42 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 22 10 — — $36,558.29 $73,825.50 $36,558.29 2026-10-16
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 22 10 — — $36,412.26 $73,518.00 $36,412.26 2026-10-16
5911 OTHER Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $36,248.30 $36,248.30 $36,248.30 2026-05-13
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 5 5 — — $36,248.30 $36,248.30 $36,248.30 2026-10-16
42 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $36,169.22 $36,169.22 $36,169.22 2026-05-13
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $36,169.22 $36,169.22 $36,169.22 2026-10-16
7594 APR_DRG Eating Disorders 5 5 — — $36,097.94 $36,097.94 $36,097.94 2026-10-16
7594 OTHER Eating Disorders 5 5 — — $36,097.94 $36,097.94 $36,097.94 2026-05-13
1664 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $35,921.03 $35,921.03 $35,921.03 2026-05-13
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $35,921.03 $35,921.03 $35,921.03 2026-10-16
471 MS_DRG Cervical Spinal Fusion With Mcc 22 10 — — $35,895.82 $72,430.50 $35,895.82 2026-10-16
1623 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $35,834.14 $35,834.14 $35,834.14 2026-05-13
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $35,834.14 $35,834.14 $35,834.14 2026-10-16
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 22 10 — — $35,722.01 $72,064.50 $35,722.01 2026-10-16
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $35,711.87 $35,711.87 $35,711.87 2026-10-16
6814 OTHER Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 5 5 — — $35,699.91 $35,699.91 $35,699.91 2026-05-13
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 5 5 — — $35,699.91 $35,699.91 $35,699.91 2026-10-16
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 22 10 — — $35,412.14 $71,412.00 $35,412.14 2026-10-16
2324 OTHER Gastric Fundoplication 5 5 — — $35,393.45 $35,393.45 $35,393.45 2026-05-13
2324 APR_DRG Gastric Fundoplication 5 5 — — $35,393.45 $35,393.45 $35,393.45 2026-10-16
152481650 OTHER Pertuzumab-trastuzumab-hyaluronidase 600 Mg-600 Mg-20,000 Units/10 Ml Inj - *Mai… 15 10 $47,116.00 $30,625.40 35% off $9,423.20 $47,116.00 $35,337.00 2026-05-13
6954 OTHER Chemotherapy For Acute Leukemia 5 5 — — $35,222.27 $35,222.27 $35,222.27 2026-05-13
6954 APR_DRG Chemotherapy For Acute Leukemia 5 5 — — $35,222.27 $35,222.27 $35,222.27 2026-10-16
924 OTHER Facial Bone Procedures Except Major Cranial/facial Bone Procedures 6 5 — — $77.70 $35,107.29 $35,107.29 2026-05-13
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 5 5 — — $35,107.29 $35,107.29 $35,107.29 2026-10-16
152470177 OTHER Vedolizumab 300 Mg Inj 15 10 $46,800.00 $30,420.00 35% off $9,360.00 $46,800.00 $35,100.00 2026-05-13
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 18 9 — — $34,989.03 $70,521.00 $34,989.03 2026-10-16
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 10 — — $34,920.64 $70,377.00 $34,920.64 2026-10-16
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 22 10 — — $34,820.91 $70,167.00 $34,820.91 2026-10-16
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 30 10 — — $10,120.00 $51,877.04 $34,584.69 2026-10-16
152470073 OTHER Ipilimumab 50 Mg/10 Ml Inj 15 10 $46,076.00 $29,949.40 35% off $9,215.20 $46,076.00 $34,557.00 2026-05-13
6 MS_DRG Liver Transplant Without Mcc 18 9 — — $34,530.29 $69,555.00 $34,530.29 2026-10-16
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 22 10 — — $34,398.50 $69,277.50 $34,398.50 2026-10-16
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